Laparoscopic Ureterocalicostomy: A Feasibility Study

Cherullo, Edward E.; Gill, Inderbir S.; Ponsky, Lee; Banks, Kevin; Desai, MihirR M; Kaouk, Jihad; Meraney, Anoop; Skacel, Marek; Sung, Gyung Tak

doi:10.1097/01.ju.0000058214.99086.37

Cited by 21 publications

(11 citation statements)

References 13 publications

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“…The use of a ureteral catheter fixed externally at the perineal area of the swine was described (CHERULLO et al, 2003). In the authors' view, such technique was associated to accidental withdrawn of the catheter before the desired moment.…”

Section: Discussionmentioning

confidence: 99%

“…Such time is supposed to be long enough to cause hydronephrosis (CHERULLO et al, 2003). Based on that fact, no image scanning was adopted to confirm the presence of hydronephrosis.…”

Section: Discussionmentioning

confidence: 99%

“…Ureterocalicostomy is indicated in case of failure of a previous ureteropyeloplasty, substantial deposition of fibrosis on the UPJ and marked impairment of tissue handling, stenosis of a large segment of proximal ureter and consequent impossibility of achieving a tension-free anastomosis, presence of intrarenal pelvis and other abnormalities. In some peculiar cases such as severe hydronephrosis, ureterocalicostomy can provide functional drainage of the collector system with resumption of the symptoms and preservation of the renal function (CHERULLO et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic ureterocalicostomy in pigs - experimental study

et al. 2015

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Section: Discussionmentioning

confidence: 99%

“…Such time is supposed to be long enough to cause hydronephrosis (CHERULLO et al, 2003). Based on that fact, no image scanning was adopted to confirm the presence of hydronephrosis.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Laparoscopic ureterocalicostomy in pigs - experimental study

et al. 2015

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“…In these patients the mean tumour size was 12.4 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) cm. CT detected the thrombus to be floating within the renal vein in seven patients and invading the renal vein wall in one.…”

Section: Laparoscopic Radical Nephrectomy In the Presence Of Level I mentioning

confidence: 99%

“…Based on this experience, this technique was applied clinically in two patients, one with a PUJ obstruction and multiple secondary calculi in a dilated, dependent lower pole calyx, and the other with a surgically failed PUJ obstruction with a scarred pelvis and significant hydronephrosis [15]. Using a transperitoneal technique, the PUJ was dismembered and suture-ligated, the cut end of the ureter spatulated, the attenuated lower pole renal parenchyma amputated, and a mucosa-to-mucosa uretero-calyceal anastomosis created with a running 4-0 absorbable suture over a J stent (Fig.…”

Section: Laparoscopic Ureterocalycostomymentioning

confidence: 99%

Advanced renal laparoscopy

Abreu

Gill

2005

BJU International

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haemorrhage in one animal; the problem was corrected laparoscopically. After surgery one animal died from pneumonia. The remaining seven animals had no complications and were utilized one each at 0 and 1 days then at 1, 2, 3, 4 and 6 weeks. The median serum creatinine values were similar (11.5 and 12 mg/L; P = 0.39) before and at the follow-up (at death). However, the peripheral renin activity before surgery (0.25 µ g/L per h) was lower than afterward, at 0.9 µ g/L per h ( P = 0.047). An ex vivo angiogram after death showed a widely patent, normal-appearing aorto-left renal artery anastomosis in all animals. On histopathology the early left renal parenchymal specimens showed transient and mild acute tubular necrosis that resolved over sequential specimens with no significant long-term sequelae. LAPAROSCOPIC SPLENO-RENAL BYPASSMore recently, this extra-anatomical technique of renal revascularization was also evaluated in the laboratory [3]. A spleno-renal bypass was created in six mongrel dogs; particularly in the canine model and unlike in the clinical scenario, there is a significant disparity in the calibre of the splenic and renal arteries. Moreover, the small diameter of the distal splenic artery (2.2-2.5 mm) made this laparoscopic end-to-end anastomosis an especially technically challenging task. Briefly, the surgical technique comprised dissection of the distal segment of splenic artery and main left renal artery, transection and spatulation of the splenic artery and left renal artery, in-situ intracorporeal renal hypothermia, end-to-end splenorenal anastomosis, and unclamping and renal revascularization. In-situ transarterial renal hypothermia was achieved using a Pruit balloon catheter, as described above (Fig. 1). To overcome the limitations related to laparoscopic free-hand suturing in this 'microsurgical' task, we paid particular attention to the following steps: optimal port placement, use of 3 mm needle-scopic instruments, synchronization of hand movements with the animal's respiratory movements, and use of 5-0 polypropylene suture on an RB-2 needle. All procedures were completed laparoscopically with no open conversion. On in vivo / ex vivo renal arteriograms after surgery the anastomosis was patent in four animals, while in two there was obstruction of the anastomotic site. LAPAROSCOPIC RENAL AUTOTRANSPLANTATIONThe feasibility of laparoscopic renal autotransplantation completely intracorporeally has been evaluated [4]. After laparoscopic left donor nephrectomy, renal hypothermia was achieved by in-situ intraarterial perfusion of ice-cold solution. The iliac artery and vein were previously dissected in preparation for autotransplantation. Laparoscopic vascular clamps were used to individually control the iliac artery and vein. The kidney was carefully positioned and stabilized in the pelvis. Individual end-to-side anastomosis of the renal artery and vein to the common iliac artery and vein were performed precisely (Fig. 2). The mean (range) operative duration was 6.2 (5.3-7.9) h, for venous anastom...

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